(HealthDay News) — Patients already prescribed angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) should continue taking their medications, according to a joint statement from the American Heart Association (AHA), the Heart Failure Society of America (HFSA), and the American College of Cardiology (ACC), issued in response to a research letter published online in The Lancet Respiratory Medicine.
In a statement, the AHA, HFSA, and ACC recommend that patients who have been prescribed ACE inhibitors or ARB medications for indications such as heart failure, hypertension, or ischemic heart disease should continue these medications. Cardiovascular disease patients who are diagnosed with COVID-19 should be fully assessed before addition or removal of medications, and changes should be based on the latest scientific evidence and shared decision making.
The statement comes in response to a research letter authored by Lei Fang, MD, PhD, from the University Hospital Basel in Switzerland, and colleagues. Noting that in 3 studies of patients with COVID-19, the most frequent comorbidities reported are often treated with ACE inhibitors and that human pathogenic coronaviruses bind to their target cells through angiotensin converting enzyme 2 (ACE2), the authors hypothesized that diabetes and hypertension treatment with ACE2-stimulating drugs may increase the risk for developing severe and fatal COVID-19. Based on this hypothesis, the authors suggest that patients with cardiac diseases, hypertension, or diabetes, treated with ACE2-increasing drugs, may be at higher risk for severe COVID-19 infection and should be monitored for ACE2-modulating medications.
“There are no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE inhibitor or ARB medications,” Richard J. Kovacs, M.D., president of the ACC, said in a statement. “These recommendations will be adjusted as needed to correspond with the latest research.”
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? [Published online March 11, 2020]. Lancet. doi: 10.1016/S2213-2600(20)30116-8